Spinal Disease

Cervical Spinal Disease

Change in Functional Status Following Cervical Decompression With Fusion for Cervical Disc Herniation

Surgical Dates: July 3, 2017-June 29, 2018

PDQ = Pain Disability Questionnaire, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient-Reported Outcomes Measurement Information System

In patients who underwent cervical decompression with fusion for symptoms of severe arm pain due to a cervical disc herniation, 264 reported a baseline impairment of physical function, defined as a Pain Disability Questionnaire (PDQ) score > 16; 49.6% noted clinically meaningful improvement after surgery and 14% worsened. Median duration of follow-up after surgery was 81 days (range, 42–420). Among patients assessed using the Patient Reported Outcomes Measurement Information System (PROMIS®), 35.2% noted clinically meaningful improvement of their Physical quality of life scores and 23.1% noted clinically meaningful improvement in their Mental scores. In this and subsequent graphs, clinically meaningful change in PROMIS scores was defined as a change of one-half of a standard deviation.¹ Among 197 patients reporting at least moderate depressive symptoms, defined as Patient Health Questionnaire (PHQ-9) score ≥ 10, at baseline, 14.7% noted clinically meaningful improvement in depressive symptoms and 76% were stable. Improvement in PHQ-9 was defined as a change of ≥ 5 points.²

Change in Functional Status Following Cervical Decompression Without Fusion for Cervical Disc Herniation

Surgical Dates: July 26, 2017 – June 26, 2018

PDQ = Pain Disability Questionnaire, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient-Reported Outcomes Measurement Information System

In patients who underwent cervical decompression without fusion for symptoms of severe arm pain due to a cervical disc herniation, 74 reported a baseline impairment of physical function (PDQ > 16); 51% noted improvement after surgery and 13.5% worsened. Median duration of follow-up after surgery was 70.5 days (range, 42–266). Among patients assessed using PROMIS, 37.9% noted clinically meaningful improvement of their Physical quality of life scores and 27.6% noted clinically meaningful improvement in their Mental scores. Among 51 patients reporting at least moderate depressive symptoms (PHQ-9 ≥ 10) at baseline, 13.7% noted clinically meaningful improvement in depressive symptoms and 64.7% were stable.

References
  1. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care. 2003 May;41(5):582-592.
  2. Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the Patient Health Questionnaire-9. Med Care. 2004 Dec;42(12):1194-1201.